面肌功能康复评价法制定机理的实验研究

An experimental study on the mechanism of the partial evaluation system for functional evaluation of the facial muscles

目的 探讨“部分评价系统”面肌功能评价法制定的机理。方法 制作豚鼠颞骨内面瘫模型 ,分为面神经压榨 3 0d 15s组、3 0d 3 0s组、60d 15s组和 60d 3 0s组 ,每组各 5只。首先行压榨前、后眼轮匝肌(简称眼肌 )和口轮匝肌 (简称口肌 )神经电图 (ENoG)最大振幅动作电位测试 ,计算百分比值。然后分别取两肌行琥珀酸脱氢酶 (SDH)、乙酰胆碱脂酶 (AchE)结合组织化学染色法 ,并应用LUZEX F图像分析系统测试各组肌纤维SDH和AchE含量的灰度值 ,以透射电镜观察线粒体和运动终板的病变程度。结果 除 60d 15s组之外 ,各组的眼轮匝肌ENoG振幅百分比值均显著小于口轮匝肌 (P <0 .0 1)。SDH、AchE活性损失程度 ,除压榨后 60d 15s组两肌间差异无显著性意义外 ,其他各组两肌间差异均有显著性意义 (P <0 .0 1)。除 60d 15s组两肌的线粒体和运动终板已基本恢复正常外 ,其他各组眼轮匝肌线粒体和运动终板的病变程度均较口轮匝肌明显。结论 面神经失神经支配后 ,眼轮匝肌与口轮匝肌相比 ,具有受损伤程度重和康复困难的特性 ,支持“部分评价系统”面肌功能评价法的合理性 。

Objective To validate the ”partial evaluation system” of the facial muscles function. Methods Twenty five Guinea pigs were used in this study. Five served as control. The other 20 animal were used to establish the model of intratemporal bone facial paralysisby cushing the facial never for 15 (15s group) and 30 seconds (30s group), respectively. And then each group was further divided into 30d and 60d groups. Five animals of each group were tested by electroneurography (ENoG).The maximum amplitude of action potential of musculus orbicularis oculi and musculus orbicularis oris was recorded before and after the crush with a ratio of the two time points being calculated. The two muscles were stained by succinate dehydrogenase (SDH) and acetylcholinesterase (AchE).The contents of SDH and AchE were tested by LUZEX F computerized pattern analysis system.The changes of mitochondria and motor endplate were observed by scanning electron microscope. Results The amplitude ratio of musculus orbicularis oculi was smaller than that of musculus orbicularis oris ( P <0.01) except that of the 60d 15s group. There was significant difference between the two muscles in the degree of activity loss of SDH and AchE ( P <0.01) except that of 60d 15s group. The mitochondria and motor endplate of the two muscles rehabilitated in the 60d 15s group. In the other groups, the degree of injury of mitochondria and motor endplate was more serious in musculus orbicularis oculi than in musculus orbicularis oris. Conclusion Musculus orbicularis oculi was more severely injured and more difficult to be rehabilitated than musculus orbicularis oris after being denervated by crushing the facial nerve. It supported the rationality of use of partial evaluation system to evaluate the residual function of facial muscles.